The U.S. House will not take up a vote on extending critical health insurance subsidies, ensuring that rates will soar into unaffordability for many of the nearly 29,000 Alaskans who buy insurance through the marketplace.
The announcement today by House Speaker Mike Johnson that he won’t allow a vote on the extension is the nail in the coffin for any long-shot hopes of stopping insurance premiums from doubling or tripling next year. The news comes the day after the deadline for Alaskans to enroll in coverage starting in 2026 (they can still sign up through Jan. 15 for coverage starting in February 2026).
It also comes a week after Alaska U.S. Sen. Dan Sullivan — one of the dozens of Republicans growing increasingly wary about their reelection prospects in 2026 — broke with a majority of Republicans to vote for Senate Democrats’ straightforward extension of the credits. The vote was purely virtue signaling as it fell well short of the 60 votes needed to break the filibuster.
Still, for other Republicans, the party’s failure to address a problem known for years led to some harsh words on Tuesday.
“This is absolute bullshit,” Rep. Mike Lawler, a New York Republican who’s also afraid of his reelection chances in 2026. “I think it’s idiotic not to have an up-or-down vote on this issue… It is political malpractice.”
The subsidies were a Biden-era policy that made buying health insurance through the marketplace — the main place for small businesses and freelancers to get coverage — free or nearly free for low-income households and nearly affordable for middle-class households.
The changes proved popular with Alaskans, leading to the highest enrollment the marketplace has seen since it was created by the Affordable Care Act. Before the credits, enrollment in the marketplace settled around 18,000 Alaskans. Enrollment spiked to 22,000 in the first year of the new subsidies. That trend has continued with the state currently sitting at 28,736 enrollees, according to KFF.
Now, state legislators, health care advocates and small business owners are worried about what it’ll mean for coverage in 2026. With costs set to, in some cases, triple from about $1,000 a month to nearly $3,000, it’s feared people will go without coverage altogether.
AK Bark owner Mark Robokoff, one of the many small business owners who rely on the marketplace for coverage, told the Anchorage Daily News that his insurance premiums are set to triple, going from $924 to $2,886, if there’s no extension of the subsidies.
“This will pull the rug out from under me,” said Robokoff. “I thought I was doing the things that a society wants its members to do — create new businesses, create new jobs, improve the life of the surrounding community.”
Republicans have pitched half-baked alternatives, including a health savings account that would give people $80 a month in health spending accounts if they are enrolled in still-costly high-deductible plans. Using your author as an example, such a plan would cost about $650 a month with a $7,500 deductible.
While Republicans have long been fixated on these types of plans under the argument that they’d empower people to shop around for health care, that’s trickier in practice, especially in places like Alaska, where there may not be multiple in-network options for care. An NPR reportv highlighted how such plans can still land people in deep health care debt.
Fumiko Chino, an oncologist at the MD Anderson Cancer Center in Houston, told the outlet that it doesn’t make sense to expect people in the middle of medical emergencies to go out and compare prices for the treatment of a potentially deadly condition.
“You’re not going be able to actually do that effectively,” Chino said, “and certainly not within the time frame that you would need to when facing a cancer diagnosis and the imminent need to start treatment.”
For many, the entire situation has highlighted the growing inequities created and reinforced by conservative leadership.
Outside the U.S. Rep. Nick Begich’s office in November, Stand Up Alaska organizer Erin Jackson told a rally that the fight for affordability extended to everyone, noting that she, too, relies on marketplace insurance and would have to rethink a medical procedure she was planning for next year. She criticized Begich and fellow Republicans as out of touch with the struggles of everyday Alaskans.
“It’s not just about people that need SNAP,” she said. “It’s people like me, who are relatively privileged, who will not have health care next year because my premiums have gone up from $497 to $2,417. So, I will not have the hip surgery that I need. I may or may not have the medication that I need … Why is his pain more important than ours?”
Matt Acuña Buxton is a long-time political reporter who has written for the Fairbanks Daily News-Miner and The Midnight Sun political blog. He also authors the daily politics newsletter, The Alaska Memo, and can frequently be found live-tweeting public meetings on Bluesky.
